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Selection and Dosing of Medications for Management of Diabetes in Patients with Advanced Kidney Disease
Author(s) -
Reilly James B.,
Berns Jeffrey S.
Publication year - 2010
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2010.00703.x
Subject(s) - medicine , dosing , diabetes mellitus , renal function , intensive care medicine , kidney disease , glycemic , disease , kidney , pharmacology , endocrinology
Diabetes mellitus is a leading cause of kidney disease worldwide. A large and expanding array of treatments for diabetes is available to improve glycemic control, including newer classes of drugs, such as thiazolidinediones and incretin‐based therapies. The presence of impaired kidney function with reduced glomerular filtration rate should influence choices, dosing, and monitoring of hypoglycemic agents, as some agents require a dosing adjustment in patients with kidney disease and some are entirely contraindicated. This article reviews the clinical use of insulin and other antidiabetic therapies, focusing on pharmacokinetic properties and dosing in patients with advanced kidney disease.